Exam 2: Thoracic Spine Flashcards Preview

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Flashcards in Exam 2: Thoracic Spine Deck (69):
1

What is the least mobile part of the spinal column designed for rigidity

The thoracic spine

2

What problems is the thoracic spine prone to

Chronic postural problems, myofascial pain syndromes

3

Biomechanical changes to t/s may result in what

Effects to sympathetic nervous system (T1-L2)

4

What limits extension in t/s

Imbrication

5

What is the the facet like for the rib articulation of the t/s

Concave facet on the anterior side

6

What degree is facet orientation

60 degrees

7

From the frontal plane toward midline what is the y axis rotation

20 degree

8

What is the inferior articular process orientation of the t/s

Ant, inf, med

9

What is the superior articular process orientation of t spine

Post, sup, lateral

10

Whats different about t/s ivd

They are comparatively thin

11

What is the disct height to body height ratio in t/s

1:5 smallest spinal ratio

12

What is special about the nucleus

Its more centrally located witihin the annulus than other

13

What is the thoracic curve

Kyphotic less than 55 degrees (avg 45)

14

What maintains the kyphotic thoracic curve

Wedge shaped vertebra (higher posteriorly)

15

Where is the apex of the thoracic curve

T6-T7

16

What problems can result of alteration of thoracic kiyphotic curve

Chronic stretch of trap, post back muscles, crowds thoracic viscera, sheurmann disease

17

What ROM is most limited in t/s

Extension due to impaction of articular processes and spinous

18

What is the primary movement of t/s

Lateral bending coupled with axial rotation

19

What is lateral bend coupled with

Axial rotation more apparent in upper t/s

20

What coupling pattern is seen T1-T4

Spinous to contralateral side during coupling

21

What coupling happens T9-T12

Spinous to more ipsilateral side like lumbar

22

Thoracic flexion and extension combine with what coupled movement

Slight +/- z translation

23

When walking where is the greatest rotation of the spine

Mid thoracics

24

What plays a role in enhancing stiffness of t/s especially in extension

The rib cage

25

When does the rib cage increase Y axis stability

During compression

26

Without muscles and rib cage the ligamentous spine can only support how much force

20N

27

What two groups does rib articulations get divided into

Costovertebral joints, costotransverse joints

28

Which ribs articulate with a single VB

Ribs 1 and 10-12

29

What rib heads also articulate with adjacent vertebra

Ribs 2-9

30

What ribs don’t have costotransverse articulations

Ribs 11-12

31

What rib heads have costotransverse articulations

Ribs 1-10

32

What ribs connect to the sternum directly via costal cartilage

Ribs 1-7 = true ribs

33

What ribs attach indirectly via shared costal cartilage

Ribs 8-10 false ribs

34

What ribs are free floating with no anterior attachement

Ribs 11-12 = floating ribs

35

Change from the coronal facet plane in the t spine to the sagittal plane facets in the l spine typically occur where

T11-T12

36

What forms the cluneal nerves

Posterior primary rami of spinal roots T12-L2

37

What syndrome could account for up to 60% of chronic and acute back pain

Maigne syndrome

38

Curves <10% are often just ____ changes

Postural

39

If a curve is >10% accompanied by vertebral rotation it is called what?

Scoliosis

40

What side scoliosis is mc

Right thoracic

41

What scoliosis is often caused by some postural problem, muscle spasm, or leg length inequality, which can often be addressed

Functional scoliosis

42

What type of scoliosis is bony distortion, does not reduce with postural maneuves

Structural scoliosis

43

At what age does scoliosis most often develop between

Ages 10-15

44

Who is mc affected by scolioses

Girls

45

Why should kids of parents or siblings are affected by scolisosis should be evaluated

Because it can be inherited

46

What idiopathic scoliosis is mc

Adolescent idiopathic scoliosis (AIP)

47

What is the ratio of girls to boys with curves >30%

10:1

48

What girls are at the highest risk of scoliosis progression

Scoliosis greater than 25 degrees and who have not had their first period

49

What is low risk percentage of progression

5-15

50

What is moderate risk of curve progression

15-40%

51

What is high risk of curve progression

40-70%

52

What is very high risk percentage of risk of curve progression

70-90%

53

What risser grade is 25% ossified

1

54

What risser grade is 50% ossified

50%

55

What risser grade is skeletal maturity

5

56

When is bracing a treatment option

For kids who have not reaching skeletal maturity and who have curves between 25-45%

57

When is surgery a treatment option for scoliosis

When curves are >45% and progressive or when it can affect vital funx

58

What are some chiropractic interventions for scoliosis

Adjust, exercise, EMS, none should be used alone

59

According to american academy of orthopedic surgeouns when should we screen girls and boys

Girls = ages 11 and 13, boys = ages 13 or 14

60

According to american academy of pediatrics when should we screen for scoliosis

Screen at 10, 12, 14, 16

61

What test asks patients to bend forward to test assymetry

Adams forward bend test

62

What angle between intersecting lines drawn perpendicular to the top of the superior vertebra and bottom of the inferior vertebra

The cobb angle

63

What brace also includes a neck ring

Milwaukee brace

64

What are the braces at successful at

74% success rate at halting curve progression

65

How often should braces be worn

23 hours a da at least 16 hours a day

66

Curves growing in children >40 degrees require what

Spinal fusion (risser grade 0-1 in girls and 2-3 in boys)

67

What do you lose in thoracic scoliosis surgery

Loss of kyphosis

68

Over time thoracic scoliosis surgery can lead to what

Loss of lumbar lordosis = flat back syndrome

69

In later years what can happen to discs below the fusion

Discs may degenerate below the fusion